Referral Specialist (528544)
Florida International University is a top public university that drives real talent and innovation in Miami and globally. Very high research (R1) activity and high social mobility come together at FIU to uplift and accelerate learner success in a global city by focusing in the areas of environment, health, innovation, and justice. Today, FIU has two campuses and multiple centers. FIU serves a diverse student body of more than 56,000 and 290,000 Panther alumni. U.S. News and World Report places dozens of FIU programs among the best in the nation, including international business at No. 2. Washington Monthly Magazine ranks FIU among the top 20 public universities contributing to the public good.
The Herbert Wertheim College of Medicine is currently seeking a Referral Specialist to join our team of professionals.
- Assists patients and their families with referrals and required authorizations as appropriate. Identifies available providers within their insurance plan provider network and facilitates linkage to and coordination with providers and service continuity work flows for complex or out of area services.
- Communicates with community providers and their office staff.
- Answers telephone inquiries from patients or providers relating to referrals/authorizations.
- Works closely with clinical support staff to advise patients regarding appointments, instructions, and special test preparations.
- Schedules hospital admissions and outpatient surgical and/or diagnostic procedures after applicable prior authorizations are obtained and coverage is verified.
- Keeps providers and patients informed of the prior-authorization process and finalizes coverage determinations.
- Utilizes available information systems and other resources to document all prior authorization activities.
- Answers and screens incoming calls in a professional, courteous and timely manner. Takes phone messages when necessary, properly informs appropriate personnel/department in a timely fashion and ensures calls are routed properly. Directs patients and visitors for appointments, tests, and meetings utilizing effective customer service techniques.
- Handles sensitive cardholder information and/or processes credit cards transactions for the department. Collects payment due as needed; prepares receipt for funds collected and provides copy to patient. Counsels patients on unpaid balances from previous visits and request payment on unpaid services. Collects and posts fees in the practice management system and according to standard operating procedure. Prepares and balances daily financial register and submits all forms and fees according to department procedures.
- Provides coverage for Patient Client Access Representative as needed.
- Works with and/or in same environment as minors and/or vulnerable persons within their role.
- Performs essential duties in any emergencies such as hurricanes, public health emergencies, and/or any other university emergency closing. The employee is expected to be available to report to work as needed during university emergency closing with appropriate notification of a department administrator.
- Performs other related duties as assigned or as directed. The omission of specific duties does not preclude the supervisor from assigning duties that are logically related to the position.
High school diploma and three (3) years of medical office experience with managed care referral and authorization process in an ambulatory health care or physician practice setting.
- Previous experience with medical referrals and authorizations.
- Previous experience providing customer support to patients.
- Excellent communication skills (written and verbal).
HOW TO APPLY
For more information or to apply, please visit us on-line at http://careers.fiu.edu and reference job opening ID JOB ID: 528544. Qualified applicants must submit a letter of interest accompanying their curriculum vitae with names and addresses of three professional references.
Florida Statute 1010.35 - Screening Foreign Researchers
Pursuant to Florida law, any citizen of a foreign county who is not a permanent resident of the U.S., or who is a citizen or permanent resident but is affiliated with or has had at least 1 year of employment or training in China, Russia, Iran, North Korea, Cuba, Venezuela, or Syria is subject to additional screening. Applicants meeting those criteria will be required to provide the following information in the application: every institution of higher education attended; all previous employment since the applicant’s 18th birthday; list of all published material, current and pending research funding from any source, including details about the research, your role, funding source, and amount; list and description of any non-university professional activities; any affiliation with an institution or program in a foreign country; a complete copy of your passport; the most recently submitted DS-160 (Online Nonimmigrant Visa Application).
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To obtain a paper copy of the report, please visit the FIU Police Department located at 885 SW 109th Avenue, Miami, FL, 33199 (PG5 Market Station).
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FIU is a member of the State University System of Florida and an Equal Opportunity, Equal Access Affirmative Action Employer all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.